Colic emergency in a pregnant horse

Jewel and her foal. (Photo courtesy of Meg Enslin and Virginia Tech)

At 6 months pregnant, Jewel, a draft mare, faced a colic emergency that threatened her life and the future of her unborn foal. At the time 5 years old, Jewel was the third horse on her farm that began to experience signs of colic in the last month.

Owned by Meg Enslin of Benchfield Farms in Newville, Pennsylvania, Jewel is trained for both wagon and carriage driving. She also competes as a farm pull horse, competing with other horses owned by local farmers in friendly competitions to determine which horse is the strongest.¹

In September 2023, Jewel started exhibiting signs of colic after a recent horse pull, according to a news release.¹ She was taken to the Marion duPont Scott Equine Center (EMC) in Leesburg, Virginia to receive emergency colic treatment.

Following an initial assessment that included blood tests and ultrasounds, Jewel was admitted to the EMC hospital for fluid therapy and close observation. Despite the treatment, her signs of colic continued, which led the veterinary team to recommend surgery.

According to a Virginia Tech (VT) news release, Enslin was very worried that the procedure might endanger Jewel's unborn foal, but ultimately decided to proceed with the surgery. "Dr Marchitello was understanding about our concerns with the cost of the procedure and the stress of the situation we were facing," Enslin said in the release.¹ "She was excellent at providing the best options while keeping in mind the costs associated with each option and was also patient and kind with explanations and options."

During exploratory surgery, veterinarians discovered that Jewel’s jejunum and duodenum were distended and filled with fluid. To alleviate this pressure, the fluid was manually decompressed into the cecum.

To further investigate Jewel’s condition, as well as the other horses on her farm who were also having similar experiences, a small intestinal biopsy was performed. This histopathological examination allowed the veterinary team to analyze dead cells. It was also discovered that Jewel's large colon had become displaced. This displacement was corrected by exteriorizing and decompressing the colon before repositioning it in its normal orientation.

Post-operative care

Following surgery, Jewel required intensive care, including continuous intravenous (IV) infusions, multimodal analgesia, antibiotics, and anti-inflammatories. She also received vitamins and gastric support to aid her recovery. However, the first few hours post-surgery were critical; Jewel produced large volumes of gastric reflux, a condition that occurs when digestive fluids back up in the stomach due to intestinal dysfunction. Unlike many animals, horses cannot vomit, making it crucial to manage this reflux effectively to prevent stomach rupture.¹

Jewel also exhibited signs of endotoxemia, a condition that can occur when inflammation or infection in the bowel leads to toxins leaking into the bloodstream. To combat this, the veterinary team gave Jewel additional anti-endotoxic therapies and provided dextrose for nutritional support.

Signs of improvement

After 2 days at the EMC, Jewel began to show signs of improvement, and her treatment plan was gradually adjusted as her condition stabilized. Laboratory tests were conducted regularly to monitor her hydration status, electrolyte levels, and immune function. Jewel was introduced to small feedings which she tolerated well, according to the release.¹ Regular fetal monitoring was also conducted, and ultrasounds confirmed that Jewel's unborn foal was active and had a normal heart rate.

The biopsy results eventually indicated a gastrointestinal infection. "After a thorough history was collected regarding farm practices, a new husbandry plan was instituted including feeding regimens, field maintenance, and deworming schedules to better support the immune systems of various horse populations on the farm," Marchitello said in the release.¹

Jewel returned to the farm after spending 8 days in the hospital “comfortable and well-hydrated with a well-healed abdominal incision.”¹ Nine days after her expected due date, Jewel gave birth to a healthy filly foal.

Reference

1. Peart S. Pregnant draft horse pulls through colic with help of Equine Medical Center. News release. Virginia Polytechnic Institute and State University. November 11, 2024. Accessed November 18, 2024. https://news.vt.edu/articles/2024/11/vetmed-emc-success-story-jewel.html